title: Should we abandon wire-guided localization for nonpalpable breast cancer? A plea for wire-guided localization.
abstract: OBJECTIVE
  To evaluate wire-guided localization for nonpalpable breast cancer regarding procedure and surgery-related outcome in a nonteaching community hospital in the Netherlands.
  
  
  METHODS
  A consecutive series of 117 patients who were treated with breast-conserving surgery after wire-guided localization for nonpalpable breast cancer between January 2006 and December 2010 was retrospectively analyzed. The patients' digital records were reviewed for patient, radiological, histological, and surgical characteristics. In order to quantify the excess resected tissue, a calculated resection ratio was determined by dividing the total resection volume by the optimal resection volume. The optimal resection volume was defined as a spherical tumor volume with an added 1.0 cm margin. The total resection volume was defined as the corresponding ellipsoid.
  
  
  RESULTS
  There were no procedure-related complications. There were two postoperative hemorrhages. Margins were clear in 92.3% of the cases after the first surgical procedure. Eight (6.8%) patients required two operations and one (0.9%) patient required three operations in order to obtain negative margins. Breast conservation was possible in 113 (96.6%) patients. The median calculated resection ratio was 1.87 (range 0.47-14.92).
  
  
  CONCLUSIONS
  This study proves that it is possible to obtain excellent results performing breast-conserving surgery for nonpalpable breast cancer regarding margin status, total amount of operations, and the ratio between tumor and resected tissue volume using wire-guided localization as a localization tool.
authors.affiliation: Department of Surgery, Ziekenhuis Rivierenland, Tiel, The Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: de Roos
authors.forename: W N
authors.initials: WN
authors.lastname: Welvaart
authors.forename: K H
authors.initials: KH
authors.lastname: Ong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D044584:Carcinoma, Ductal / Q000175:diagnosis / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D015412:Mastectomy, Segmental / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Breast cancer; breast-conserving surgery; ductal carcinoma in situ; margin status; resection volume; wire-guided localization